Individual provider Active NPI

Elizabeth Maria Llewellyn, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1730158593
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
03585 Issued in GA
Practice address
2743 Brookgrove CT SE
Atlanta, GA 30339-5329
Phone
(404) 352-3233
Fax
(770) 988-0563
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 03585 GA Primary

Addresses

Primary practice location

2743 Brookgrove CT SE
Atlanta, GA 30339-5329

Mailing address

2743 Brookgrove CT SE
Atlanta, GA 30339-5329
Phone (404) 352-3233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003585GAMDFamily Medicine Physician
03585GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shubhang Mazumdar MD Past Accepting new patients
Zilmed, Inc. PastSince Oct 1, 2014 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1730158593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2743 BROOKGROVE CT SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395329",
            "telephone_number": "404-352-3233",
            "fax_number": "770-988-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2743 BROOKGROVE CT SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395329",
            "telephone_number": "404-352-3233",
            "fax_number": "770-988-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLEWELLYN",
        "first_name": "ELIZABETH",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "03585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.